This patent specification relates to the field of ultrasound information processing. In particular, it relates to a method and system for detecting and displaying fluid flow in medical ultrasound applications.
In recent decades ultrasonic imaging technology has played an increasing role in examining the internal structure of living organisms. The technology has applications in diagnosis of various medical ailments where it is useful to examine structural details in soft tissues within the body. Ultrasound imaging systems are advantageous for use in medical diagnosis as they are non-invasive, easy to use, and do not subject patients to the dangers of electromagnetic radiation. Instead of electromagnetic radiation, an ultrasound imaging system transmits sound waves of very high frequency (e.g., 2 MHz to 10 MHz) into the patient and processes echoes reflected from structures in the patient""s body to derive and display information relating to these structures.
As described in Zagzebski, Essentials of Ultrasound Physics (Mosby 1996), which is incorporated by reference herein, principal pulse-echo ultrasound display modes includes A-mode (amplitude mode), B-mode (brightness mode), and M-mode (motion mode). An A-mode (amplitude mode) display is a simple plot of instantaneous echo amplitude versus time, measured after the transmission of an acoustic pulse along a single line of a target region. A B-mode (brightness mode) image is a two-dimensional intensity image of echo amplitude for all points in a target region, measured and continually refreshed as acoustic pulses are transmitted along different lines in the target region. An M-mode (motion mode) display is a one-dimensional intensity image of echo amplitude along a single line in the target region that is slowly swept across the screen as time moves forward. Of these principal echo display modes, only the B-mode display provides an actual 2-D xe2x80x9cvisualxe2x80x9d representation of the acoustic reflectivity of tissues in the target region.
More recently, ultrasonic imaging systems have additionally been able to detect fluid flow (e.g., blood flow) in a target region. The detection and measurement of fluid flow is based on the Doppler effect, whereby returned acoustic signals reflected from the flowing fluid are shifted in frequency with respect to the incident interrogating signals. In color Doppler imaging, also referred to as color flow imaging, a sequence of pulses is transmitted down each line in the target region, and phase changes in the echo signals are detected and processed to determine the direction and velocity of fluid flow for each location in the target region. As known in the art, the measured flow direction is only a binary metricxe2x80x94either xe2x80x9ctowardxe2x80x9d or xe2x80x9caway fromxe2x80x9d the transducerxe2x80x94because fluid flow can only be detected in terms of its projection along the path of the incident interrogating pulse. Thus, the true fluid velocity can only be measured to within a factor of cos(xcex8d), where xcex8d is the angle between the actual fluid flow direction and the path of the incident interrogating pulse. The term Doppler frame is used herein to denote a timewise-adjacent sequence of pulses for determining fluid velocity at each location in a target region.
In conventional color Doppler imaging, color Doppler frames are transmitted during time intervals lying between conventional B-mode frames. In a typical conventional ultrasound system having color Doppler capability, a flow image containing the flow information is superimposed on a conventional B-mode image output. In the resulting display, stationary tissue is depicted by a standard B-mode intensity value, while flowing fluid is depicted by red (for fluid flowing toward the probe) or blue (for fluid flowing away from the probe). The measured velocity at each location is typically indicated by a color saturation or luminance value, whereby low velocities are depicted by xe2x80x9cdimxe2x80x9d color and high velocities are depicted by xe2x80x9cbrightxe2x80x9d color.
An alternative to color Doppler imaging, referred to in the art as power Doppler, power flow, or energy flow imaging, does not measure the direction or velocity of fluid flow. Rather, only the amount of Doppler energy in the echo signal is measured for each location in the target region. Thus, for a given location in the target plane receiving the sequence of xe2x80x9cmxe2x80x9d Doppler pulses, where the magnitude and phase of the reflections are given by a complex sequence R(k)={R1, R2, R3 , . . . , Rm}, the complex sequence R(k) is high-pass filtered to remove effects of stationary tissues. The remaining signal represents the Doppler energy in the sequence R(k). Conventional power Doppler systems display a flow image that is a monochromatic or color intensity image of this Doppler energy, the flow image being superimposed on a conventional B-mode display. As described in Zagzebski, supra, power Doppler systems are usually credited with being more sensitive to the presence of fluid flow as compared to color Doppler systems, while being generally insensitive to the actual velocity of the fluid flow. Other tradeoffs and comparisons between color Doppler and power Doppler modes are described in Zagzebski, supra.
One disadvantage of conventional Doppler systems (color Doppler or power Doppler) lies in their lack of frame rate and spatial resolution as compared to B-mode systems. While a typical B-mode system may have a frame rate of 30 frames/sec at a spatial resolution of 1024 lines at 1024 samples/line, the invocation of a Doppler feature can drop the frame rate to as low as 8 frames/sec, with the flow image being a mere 64 lines at 64 samples/line. It is to be appreciated that these parameters are presented by way of example only in order to illustrate certain aspects of the prior art, and are not intended to limit the scope of the preferred embodiments disclosed infra. A primary reason for the low frame rate and resolution for Doppler systems lies in the substantial number of data samples needed per location to get acceptable velocity measurement accuracy. The number of data samples per location corresponds to the number of pulses (vectors) that need to be sent down a given line during Doppler frame acquisition. According to the uncertainty principle, the frequency shift cannot be detected accurately when the observation period is short. Although interleaving schemes known in the art (e.g., fire vector 1 for line 1, vector 1 for line 9, vector 2 for line 1, etc.) can increase the time spacing between vectors without decreasing the frame rate, there is still a substantial number of vectors needed per line (e.g., 24) to get acceptable frequency shift (i.e., velocity) measurements. Each vector needs a dedicated round-trip time from the probe, a 10-cm trip in a typical scenario. Using the speed of sound at 13 xcexcs/cm, then the Doppler frame acquisition time is equal to (13 xcexcs/cm)(10 cm/vector)(64 lines/frame)(24 vectors/line)=199.7 ms/frame. And, as stated supra, this all needs to take place between B-frames, resulting in very low overall frame rates. Furthermore, although the frame rate may be increased by decreasing the number of samples per location or by decreasing the number of locations considered, lower resolution and/or velocity accuracy will result.
Another problem found in conventional Doppler systems relates to clutter. Clutter signals, sometimes referred to as flash artifacts, are undesirable Doppler signals that arise from structures and targets in the body that do not represent fluid flow but which nevertheless may have Doppler shifts. Clutter signals may be caused by slow tissue or vessel wall motion arising from heart beats, arterial pulsations, or respiration. Clutter signals can also arise due to movement of the transducer by the operator. These unwanted signals are typically filtered out, so that the flow image only represents true fluid flow and suppresses clutter. Clutter signals that have not been adequately suppressed are subsequently confused with flow signals, and are typically seen in the flow image as color displayed outside of regions where there is fluid flow, i.e., where it is anatomically implausible. As described below, however, conventional prior art methods of suppressing clutter signals can cause substantial distortions in the measured fluid velocity.
FIG. 1 shows a block diagram of a conventional Doppler system 100 designed to have Doppler capability as well as B-mode capability. Doppler system 100 comprises a transducer 102 that sequentially introduces B-mode frames and Doppler frames into a target region and receives B-mode echo frames and Doppler echo frames therefrom. As discussed supra, the Doppler frames are typically limited to a smaller target region than the B-mode frames. A front end processor 104 performs preliminary processing on the data as described in Ser. No. 09/493,969, supra, including digitization of the received signal, referred to as the RF signal, into a digitized RF signal x(k) at a sampling frequency Fs. Doppler system 100 further comprises a prior art demodulator 106 that receives the RF signal x(k) and demodulates it from its carrier frequency Fc into component baseband signals I(k) and Q(k), where I(k) is the in-phase component and Q(k) is the quadrature phase component, and where the complex baseband signal A(k)ejxcfx86(k) is equal to I(k)+jQ(k).
Prior art demodulator 106 comprises a local oscillator 116, mixers 118 and 120, and low pass filters 122 and 124. Local oscillator 116 generates sinusoids at a mixing frequency Fx that are in quadrature phase with each other, e.g., cos(2xcfx80Fxk) and sin(2xcfx80Fxk). Mixers 118 and 120 multiply the digitized RF signal x(k) with the quadrature-phase sinusoids, and the products are sent to low-pass filters 122 and 124, respectively. Disadvantageously, low-pass filters 122 and 124 are required to have sharp rolloffs at an upper frequency limit for proper mirror-canceling effect, which in practicality creates large group delay distortion, ringing, and other effects that compromise the quality and accuracy of the signals I(k) and Q(k).
For purposes of clarity, and not by way of limitation, the following notational explanations and clarifications are presented for use in the present disclosure. The notational representation A(k)ejxcfx86(k)=I(k)+jQ(k) of the data stream appearing at the output of demodulator 106 would, of course, have a continuous-time representation of A(t)ejxcfx86(t), where t=kTs and Ts=Fs. A particular data sample A(k0)ejxcfx86(k0) at time k0 represents the magnitude and phase of the demodulated ultrasound echo signal for a particular point (x0,y0) in the target region for a particular frame number xe2x80x9cn0xe2x80x9d in the sequence of interrogating frames. The phase xcfx86(k0) is the phase as measured against the phase of the interrogating pulse sent down the line of the sample point (x0,y0). There exists a one-to-one mapping between each value of xe2x80x9ckxe2x80x9d and an index set (x,y,n), where xe2x80x9cxxe2x80x9d and xe2x80x9cyxe2x80x9d are target locations and xe2x80x9cnxe2x80x9d is the frame number. If a coordinate system is chosen such that the xe2x80x9cxxe2x80x9d dimension is orthogonal to the direction of the interrogating pulse, and such that the xe2x80x9cyxe2x80x9d direction is parallel to the direction of the interrogating pulse, then temporally adjacent samples at indices k0 and (k0+1) correspond to spatially adjacent samples at indices (x0,y0,n0) and (x0,y0+n0) for the frame n0, as summarized in Eqs. (1) and (2) below:
A(k0)ejxcfx86(k0)=A(x0, y0, n0)ejxcfx86(x0,y0,n0)xe2x80x83xe2x80x83{1}
A(k0+1)ejxcfx86(k0+1)=A(x0, y0+1,n0)ejxcfx86(x0,y0+1,n0)xe2x80x83xe2x80x83{2}
For purposes of the present disclosure, it is to be appreciated that the data stream A(k)ejxcfx86(k)=I(k)+j Q(k) may be temporally cached and rearranged as needed for subsequent processing using methods known in the art. For example, instead of sequentially transmitting samples for (x0,y0,n0), (x0,y0+1,n0), (x0,y0+2,n0), , etc. down a particular data path, which corresponds to the original order k0, k0+1, k0+2, etc. received temporally from of the demodulator 106, the data samples may be rearranged such that they are sent in frame-sequential order for a fixed target location, i e., in the order (x0,y0,n0), (x0y0,n0+1), (x0,y0,n0+2), etc. Circuitry for accomplishing such rearrangement is known in the art and, unless otherwise indicated, is presumed to be present as required to permit the disclosed functionality to proceed.
Further, for purposes of clarity of disclosure, when data corresponding to sequential ultrasound frames at a fixed location (x, y) is presented, the following notation shall be used herein:
A(x,y,n)ejxcfx86(x,y,n)xe2x89xa1Axy(n)ejxcfx86xy(n)xe2x80x83xe2x80x83{3}
I(x,y,n)xe2x89xa1Ixy(n)xe2x80x83xe2x80x83{4}
Q(x,y,n)xe2x89xa1Qxy(n)xe2x80x83xe2x80x83{5}
Finally, it is to be appreciated that in conventional ultrasound systems having Doppler capability, the Doppler frames are generally processed separately from the B-mode frames after being demodulated by demodulator 106. In particular, the B-mode frames and Doppler frames are generally treated as separate sequences. For clarity of disclosure, and unless otherwise indicated, the counter variable xe2x80x9cnBxe2x80x9d shall be used for B-mode frame data, while the counter variable xe2x80x9cnDxe2x80x9d shall be used for Doppler frame data.
Doppler system 100 of FIG. 1 further comprises an amplitude detector 108 coupled to the output of demodulator 106. As described supra, caching and rearranging circuitry (not shown) is used to extract B-mode frames only from the output of demodulator 106 for input to the amplitude detector 108. For each target region location (x,y), amplitude detector 108 detects the amplitude Axy(nB), the result representing the B-mode intensity value for that location. The result is then sent to an ultrasound display device.
Doppler system 100 further comprises wall filters 110 and 112, as well as a velocity estimator 114, for generating a flow image. As described supra, caching and rearranging circuitry (not shown) is used to extract Doppler frames only from the output of demodulator 106 for input into the wall filters 110 and 112. Wall filter 110 receives, for each location (x,y), the signal Ixy(nD) and filters that data stream framewise, i.e., with respect to the counter nD. Wall filter 112 performs a similar filtering for the data stream Qxy(nD). Wall filters 110 and 112 are similar to notch filters having a notch at the DC frequency, for filtering out the effects of slow-moving clutter. Velocity estimator 114 receives the outputs Iwxy(nD) and Qwxy(nD) from the wall filters 110 and 112, respectively. From these sequences, velocity estimator 114 computes a phase sequence xcfx86xy(nD) and, as known in the art, proceeds to compute a fluid flow velocity as being proportional to the derivative dxcfx86xy/dnD at that location. Further information on Doppler systems similar to the Doppler system 100 can be found in U.S. Pat. No. 5,228,009 to Forestieri et. al., which is incorporated by reference herein.
Several disadvantages are incurred by the Doppler system 100 of FIG. 1. As described supra, several Doppler frames (for example, 8 to 16 frames) must be transmitted between B-mode frames, substantially slowing down the overall frame rate, forcing poor flow image resolution, and forcing small area coverage for the flow image. Furthermore, because the wall filters 110 and 112 can only operate on a stream 8 to 16 samples of data (the number of Doppler frames sent between B-mode frames), a high degree of frequency leakage and distortion is introduced, causing either a high degree of insensitivity or, alternatively, a high degree of clutter artifacts to be present in the flow image. Even further, substantial inaccuracy in the phase angle xcfx86xy(nD), and therefore the measured flow velocity, is introduced by virtue of the separate wall-filtering of the in-phase component Ixy(nD) and the quadrature phase component Qxy(nD) prior to computation of the phase angle xcfx86xy(nD).
It has been found that certain medical procedures would be made easier and more effective if real-time ultrasound images could be provided that identify areas of fluid flow in a target region with a high spatial resolution. As an example, during a breast biopsy procedure a probe needle is inserted into a woman""s breast for extracting sample tissue from a suspicious lesion. It would be desirable to provide a high-resolution flow image which, when superimposed on a B-mode image, could be used to help guide the needle to the lesion without puncturing veins or arteries in the breast.
It has been found that the conventional Doppler system 100 yields a frame rate that is too slow and a flow image resolution that is too low for medical applications such as the above biopsy application. Additionally, there is often a temporal mismatch between the B-mode image and the flow image because of the different processing times needed. In addition to being disadvantageous in the above biopsy application, this temporal mismatch is also disadvantageous in cardiology applications where the valve movement of heart is mismatched with the fluid flow image of the blood moving through the heart.
FIG. 2 shows an ultrasound system 200 which represents a prior art design for generating a flow image from B-mode ultrasound frames. Imaging system 200 comprises a transducer 202 and front end processor 204 similar to the transducer 102 and front end processor 104 of FIG. 1. Ultrasound system 200 further comprises a demodulator 206 similar to the demodulator 106 of FIG. 1, with elements 216-224 operating in a similar manner to elements 116-124 respectively, of FIG. 1. Ultrasound system 200 further comprises an amplitude detector 208 for generating B-mode image data that is similar to amplitude detector 108 of FIG. 1. However, instead of using separate Doppler frames between B-mode frames to detect fluid flow, ultrasound system 200 attempts to derive flow information from the B-mode frames themselves. In particular, ultrasound system 200 comprises an amplitude change detector 210 coupled to receive amplitude values Axy(nB) from the amplitude detector 208 and to generate flow image values based on changes in the amplitude values across multiple frames. Ultrasound system 200 operates based on the theoretical principal that, for a given location in the target region, small changes in B-mode intensity between frames will occur if there is fluid flow at that location. Descriptions of various prior art designs that use changes in B-mode amplitude between frames to detect fluid flow can be found in U.S. Pat. No. 5,980,459 to Chiao et. al., which is incorporated by reference herein.
The prior art ultrasound system 200, however, is difficult to implement in practice because the B-mode intensity for fluid regions is already very small (i.e., fluid such as blood has a small acoustic reflectivity compared to the surrounding tissue), and amplitude changes between frames due to fluid flow are even smaller. The resulting flow image is often too noisy for practical use. Additionally, because of the disadvantages of prior art demodulator 206 as described in Ser. No. 09/493,969, supra, inter-frame amplitude comparisons can be inconsistent because the amplitude measurements themselves may be subject to group delay distortion and other adverse effects, further degrading the flow image.
Accordingly, it would be desirable to provide an ultrasound imaging system capable of processing B-mode ultrasound frames to derive flow information in addition to B-mode intensity information for a target region.
It would be further desirable to provide such an ultrasound system yielding a flow image with a high frame rate and with a spatial resolution as great the B-mode image resolution.
It would be still further desirable to provide such an ultrasound system in which the flow image is robust against clutter effects, such that the presence or absence of fluid flow at a given location is readily and reliably perceived by a user.
It would be still further desirable to provide such an ultrasound system in which there is minimal temporal mismatch between the B-mode image and the flow image.
It would be even further desirable to provide an ultrasound system that can be adapted to generate accurate flow velocity information for very slow moving fluids moving slower than a predetermined maximum velocity.
It would be still further desirable to provide such an ultrasound system that is relatively inexpensive to implement, easy to use, and easy to adjust for optimal flow image output.
According to a preferred embodiment, an ultrasound imaging system is provided in which B-mode echo frames are used to derive phase information for each location in a target region, wherein changes in the phase information across multiple frames is processed for detecting the presence of fluid flow at that location. A demodulator receives the B-mode echo frames and demodulates them into baseband signal components (e.g., in-phase and quadrature components), and the phase information is derived therefrom. In accordance with a preferred embodiment, the demodulator should be highly accurate and robust, such that frame-to-frame change in the phase information is reliably measured for a given target location. From the reliably measured phase information, a phase shift metric is then computed and compared to a first threshold value. Flow is determined to be present if the phase shift metric is greater than the first threshold value, and is determined to be absent otherwise. If flow is detected, the flow image is set to a constant value for that location, and is set to a null value otherwise. Alternatively, if flow is detected, the flow image may be set to a different non-null value, such as a color value modulated by the B-mode intensity at that location. The user may adjust the first threshold value in real time through an input device, such as a knob or keyboard, to increase or decrease the flow sensitivity as desired and/or to eliminate the slow-moving clutter.
In a preferred embodiment, the phase shift metric is computed for each location by forming a difference sequence from the phase information, averaging the difference sequence, computing the absolute value of the averaged difference sequence, and then filtering the result with a contrast-preserving temporal filter. The contrast-preserving temporal filter is a time-varying, first order, infinite impulse response filter designed to have a fast attack time during a systolic cycle period and a slow decay time during a diastolic cycle period. Prior to comparison with the threshold value, the phase shift metric may be averaged with that of neighborhood locations in the target region.
For additional clutter removal, the flow image value at a target location may be further modified depending on the B-mode image value at that location. In accordance with a preferred embodiment, the B-mode image value is compared to a lower threshold value and an upper threshold value. If the B-mode image value is greater than the upper threshold value, then the flow image value is reset to null, because that location likely represents a slow-moving object such as a vessel wall. If the B-mode image value is less than a lower threshold value, then the flow image value is also reset to null, because that location likely represents noise. If the flow image value was already a null value, no B-mode image value comparison is performed and the B-mode image value is displayed for that pixel.
In an optional mode of operation in which fluid flow is assumed to be very slow, i. e., less than a predetermined Nyquist velocity, the phase information may be conventionally processed to produce a color flow image indicating a measured fluid flow velocity. In this circumstance, the measured velocity is computed as being proportional to a first derivative of the temporal phase information.
Advantageously, especially when used in conjunction with the demodulator of parent application Ser. No. 09/493,969, an ultrasound imaging system according to the preferred embodiments provides a flow image that is as large as the B-mode image, has the same high frame rate as the B-mode image, has the same high resolution as the B-mode image, and is temporally and spatially matched to the B-mode image. The provided system is also robust against clutter effects, relatively inexpensive to implement, easy to use, and easy to adjust for optimal flow image output.